World AIDS Day

Debate between David Burton-Sampson and Danny Beales

Wednesday 27th November 2024 Westminster Hall

[Danny Beales]

I definitely pay tribute to Martyn Butler and to everyone like him who has tirelessly campaigned for change. It is the perfect example of progress being made through the sheer determination of those affected by HIV and of their loved ones—those who unfortunately they left behind. My hon. Friend and I have had the pleasure of meeting many tireless campaigners and fantastic organisations such as THT.

Before entering Parliament, I worked for the National AIDS Trust, another fantastic organisation in the sector, campaigning to end new transmissions of HIV and improve the lives of those who are already living with HIV. That included working on a campaign for equal fertility rights for people living with HIV. I was delighted that just last month the law was finally changed to allow equal access to fertility treatment. That life-changing development means that people I met during that campaign can now have a family. It is not often that we can say that children will be born because of a statutory instrument, but in this case it is true. I thank the Minister for his swift leadership and action on the issue and every single person who campaigned to make that possible—thank you.

The first project that I worked on at the National AIDS Trust was a collaboration with the Elton John AIDS Foundation and the Terrence Higgins Trust: the independent HIV Commission. It heard from experts and from those with lived experience and toured the country to look at good practice. Its recommendations laid out a framework for turning into a reality the goal of ending new HIV cases in England by 2030. One of the independent commissioners was a little-known, shy and retiring Back-Bench Labour MP who is now my right hon. Friend the Member for Ilford North (Wes Streeting). He went on to somewhat bigger and better things in the world of healthcare.

A lot has changed since 2021 when the report was launched. Unfortunately, when it comes to progress on ending transmissions, a lot has not. To their credit, the last Government should be proud of the investment that they made in piloting opt-out HIV and hepatitis testing in emergency departments in London, Manchester and Brighton—the one key action in the last HIV action plan that was delivered on. That investment has changed many, many lives. In my constituency, opt-out testing at Hillingdon hospital has picked up 15 new cases of HIV, 28 of hepatitis C and 140 of hepatitis B. Those are people whose lives have been changed and who now have access to vital treatment. The story is the same across all the hospitals delivering that amazing programme.

The programme is working, but it is facing a funding cliff edge. I welcome the commitment to expand the programme further to other towns and cities, but I hope that the Government will commit to continuing the pilot where it is already in place and working.

We now know for certain that opt-out testing works. We cannot find everyone with undiagnosed HIV if we rely only on a system of people thinking that they may be at risk and then actively seeking out a test, navigating the complex system and overcoming the stigma of HIV to ask for a test. Instead, we must test, test, test. We need an opt-out testing programme that goes right across the health service and into primary care.

Unfortunately, the reality is that despite the success of the testing programme, overall progress towards ending HIV transmissions has been far too slow. Recent figures suggest that this year we are potentially moving backwards. Recent data showed an increase in cases; we have seen poor outcomes around late diagnosis; and the disproportionate outcomes for women and people from black and Asian backgrounds continue. The gap has not closed.

[David Burton-Sampson (Southend West and Leigh) (Lab)]

My hon. Friend is quite right: a disproportionate number of black, Asian and minority ethnic individuals are becoming infected with HIV. Does my hon. Friend think that it is right to raise awareness of things like PrEP in communities that may be disproportionately affected, so that we can put them in the same position as the majority of the country, whose infection rates are declining?

[Danny Beales]

I thank my hon. Friend for that vital point. HIV is a condition that knows no boundaries. It does not affect any one type of person: there is no one community that is alone affected by HIV. It knows no boundaries; it affects everyone.

After 14 difficult years for the health service, we are not on track to reach the 2030 goal. At every single stage of the HIV treatment process, we are missing critical opportunities to get people on PrEP, test for HIV and ensure that everyone living with HIV has the support that they need.

Pre-exposure prophylaxis—we can see why it is called PrEP for short—is an incredible advance in HIV prevention. It is a simple daily pill, now in generic form and therefore incredibly cheap, that prevents HIV completely if taken correctly. I have spoken before about how life-changing a drug it is in removing the fear and stigma of HIV. As a gay man who grew up in the 90s and noughties, the legacy of HIV has always weighed on me and, I am sure, on many others like me. Our sense of self, our sexuality and our relationships were always intertwined with the stigma and presence of HIV. Being able to take PrEP is game-changing, and not just for the individual and their wellbeing: it has a massive public health benefit. It has driven the significant falls in new transmissions, particularly among gay men, who have largely been the people who have accessed the drug to date.

It is unacceptable that the drug is not being accessed by everyone who could benefit. The average wait list for this preventive medicine is 12 weeks. We know from research that people have acquired HIV while waiting to access the drug. That is a significant failure that I hope the new HIV action plan will address, as well as turbocharging access outside sexual health services—the only place where it can currently be accessed. It is entirely wrong that NHS silos are holding back access to PrEP in primary care, including in pharmacy and other settings.

It is also unacceptable that people cannot get a postal test for HIV and sexually transmitted infections in 30% of rural England. It makes no sense that my borough of Hillingdon—not so rural, but on the edge of London—has a completely different postal testing system from the 30 other London boroughs that have their own system. Far too often, the patient is left to navigate complex systems. What test they get will vary depending on where they live. In vast swathes of the country, there is no option to test at home, although sexual health services are often inaccessible and chronically overwhelmed. Far too often, the individual has to fight for an appointment, and only those with the sharpest elbows, or persistence, get access to the sexual health services that they need.